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The association between lifestyle factors and Parkinson's disease progression and mortality
Author(s) -
Paul Kimberly C.,
Chuang YuHsuan,
Shih IFan,
Keener Adrienne,
Bordelon Yvette,
Bronstein Jeff M.,
Ritz Beate
Publication year - 2019
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.27577
Subject(s) - parkinson's disease , association (psychology) , disease , medicine , gerontology , degenerative disease , psychology , psychotherapist
Background Lifestyle factors may contribute to the development of Parkinson's disease, but little is known about factors that influence progression. The objective of the current study was to examine whether caffeine or alcohol consumption, physical activity, or cigarette smoking is associated with progression and survival among PD patients. Methods We assessed lifelong coffee, tea, and alcohol consumption, smoking, and physical activity in a prospective community‐based cohort (n = 360). All patients were passively followed for mortality (2001‐2016); 244 were actively followed on average ± SD 5.3 ± 2.1 years (2007‐2014). Movement disorder specialists repeatedly assessed motor function (Hoehn & Yahr) and cognition (Mini‐Mental State Exam). We used Cox proportional hazards models and inverse probability weights to account for censoring. Results Coffee, caffeinated tea, moderate alcohol consumption, and physical activity were protective against at least 1 outcome. Smoking and heavy alcohol consumption were associated with increased risks. Coffee was protective against time to Hoehn & Yahr stage 3 (hazard ratio, 0.52; 95% confidence interval, 0.28‐1.01), cognitive decline (hazard ratio, 0.23; 95% confidence interval, 0.11, 0.48), and mortality (hazard ratio, 0.47; 95% confidence interval, 0.32‐0.69). Relative to moderate drinkers, those who never drank liquor and those who drank more heavily were at an increased risk of Hoehn & Yahr 3 (hazard ratio, 3.48; 95% confidence interval, 1.90‐6.38; and hazard ratio, 2.16; 95% confidence interval, 1.03, 4.54, respectively). A history of competitive sports was protective against cognitive decline (hazard ratio, 0.46; 95% confidence interval, 0.22‐0.96) and Hoehn & Yahr 3 (hazard ratio, 0.42; 95% confidence interval, 0.23‐0.79), as was physical activity measured by metabolic‐equivalent hours. Current cigarette smoking was associated with faster cognitive decline (hazard ratio, 3.20; 95% confidence interval, 1.02‐10.01). Conclusions This population‐based study suggests that lifestyle factors influence PD progression and mortality. © 2019 International Parkinson and Movement Disorder Society